The parenting responsibility and emotional preparedness (PREP) screening tool: a 3-item screen that identifies teen mothers at high risk for nonoptimal parenting.

OBJECTIVE To test the ability of a 3-item screening tool (Parenting Responsibility and Emotional Preparedness [PREP]) to detect adolescent mothers at elevated risk for nonoptimal parenting and poor child development outcomes at 2 years of age. DESIGN A 4-site prospective cohort study conducted from December 2001 to August 2007 of adolescent mothers recruited in the third trimester of pregnancy and followed up at 4, 8, 18, and 24 months post partum. SETTING Community clinics and home settings in Birmingham, Alabama; Kansas City, Kansas and Missouri; South Bend, Indiana; and Washington, DC. PARTICIPANTS A total of 270 first-time adolescent mothers (aged 15-19 years) and their infants (birth to 2 years of age). MAIN EXPOSURES Naturalistic observations of parent-child interactions and quality of home environment during the first 2 years of life. OUTCOME MEASURES Maternal mental health and cognitive indicators, positive mother-child interactions, quality of home environment, child social-emotional development, and child cognitive development (Bayley scales). RESULTS PREP scores identified adolescent mothers with significantly elevated depressive symptoms and childhood trauma and lower scores of knowledge of infant development and maternal IQ. PREP predicted significantly lower quality of home environments and higher levels of nonoptimal mother-child interactions at 4, 8, and 18 months. PREP also predicted significantly lower child outcomes at 2 years of age for cognitive scores and higher levels of depressive and withdrawal symptoms and dysregulation and negative emotionality. CONCLUSIONS PREP is a low-cost, easily administered, nonstigmatizing screening tool that identifies adolescent mothers who self-recognize that they need help to meet their infants' social, emotional, and cognitive needs.

The influence of religiosity and spirituality on adolescent mothers and their teenage children.

This project assessed the influence of religiosity and spirituality on the socioemotional and behavioral adjustment of 110 adolescent mothers and their teenage offspring at age 14. Maternal religiosity, measured prenatally and when children were 3, 5, and 8 years of age, was defined as involvement in church as well as contact with and dependence on church officials and members. Levels of spirituality, defined as religious practices and beliefs, were assessed for both mothers and their children at 14 years postpartum. Hierarchical regression analyses suggested that maternal religiosity was a strong predictor of maternal and child adjustment; children's own spirituality served as a predictor of their socioemotional adjustment as well. Furthermore, child spirituality mediated the relationship between maternal religiosity and children's externalizing behavior. Implications for designing intervention programs with high risk families are discussed.

Depression among a sample of first-time adolescent and adult mothers.

PROBLEM: Little is known about the rates, correlates, and consequences of depression among a sample of first-time mothers. METHODS: Four-site prospective study of the first 3 years of life among first children born to first-time mothers, including adolescent (N= 396), lower- (N= 169), and higher-resource adult (N= 117). Mothers were administered the Beck Depression Inventory prenatally and 6 months postpartum. Measures of maternal and infant behaviors were taken at 8 months. FINDINGS: Adolescent mothers displayed higher prenatal and 6-month rates of depression than lower- and higher-resource adult mothers, with significantly more adolescent mothers "consistently" depressed at the two time points than lower- and higher-resource adult mothers. Further, adolescent mothers were significantly more likely to become depressed after their babies were born than lower- or higher-resource adult mothers. Depression was negatively related to parenting practices and babies' behavior. As depression increased, mothers scored less favorably in maternal warmth and sensitivity, contingent responsiveness, and general verbalness; children scored less favorably in warmth seeking toward their mothers. CONCLUSION: Findings signify the need for counseling and nurse-based intervention and prevention services geared at preparing pregnant adolescents for motherhood.

The Influence of Maternal History of Abuse on Parenting Knowledge and Behavior.

This study examined the intergenerational transmission of abuse among a sample of 681 teen, adult low, and adult high resource first-time mothers. Participants ranged in age from 14 to 36 years, with a mean of 20 years. Exposure to childhood emotional and physical abuse was associated with 6-month parenting behavior; but not parenting knowledge. Teen mothers, as opposed to adult mothers, had higher mean scores for exposure to childhood emotional and physical abuse. Adult high resource mothers reported lower mean scores on each abuse outcome than both teen and adult low resource mothers. For the total sample of mothers, as past exposure to emotional and physical abuse increased, maternal responsivity decreased, and opinions towards, and propensities for, abusive behavior increased.

Parent training: implementation strategies for adventures in parenting.

Adventures in Parenting, an informational booklet published by the National Institute of Child Health and Human Development, offers five principles that parents can use to develop a mental model of parenting: Responding, Preventing, Monitoring, Mentoring, and Modeling (RPM3). The current study was designed to assess the differential impact of three intervention conditions utilizing Adventures in Parenting on knowledge of RPM3 principles. Significant intervention effects were found for measures of knowledge of RPM3 principles; the more intensive interventions (i.e., face-to-face groups and web-based sessions) were associated with increased knowledge of RPM3 principles over 3 months. Results are discussed in terms of their contribution to new approaches of parent education, particularly the use of web-based training. Editors' Strategic Implications: Parent educators should review the promising findings regarding the RPM3 model. Preventionists, more broadly, may be interested in the effect of the program's delivery mechanism, with a comparison of participants who were randomly assigned to web-based, group-based, and booklet only conditions.